In der heutigen Zeit sind ca. 4000 Verbindungen bekannt, denen die Fähigkeit nachgesagt wird, eine Kontaktallergie auslösen zu können. Die Entscheidung, ob ein Stoff hautsensibilisierende Eigenschaften besitzt, wird dabei meist auf der Grundlage von Beobachtungen am Menschen und/oder von tierexperimentellen Befunden getroffen. Bedingt durch den vermehrten Einsatz exotischer Pflanzen und neu entwickelter synthetischer Substanzen im Bereich der Kosmetikindustrie besteht der Bedarf an einer einfachen Methode zur Vorhersage des kontaktallergenen Potentials einer Verbindung. Als zentraler Schritt bei der Manifestierung einer Kontaktallergie wird die Bildung eines Hapten-Carrier-Komplexes aus dem niedermolekularen Kontaktallergen (Hapten) und Hautproteinen (Carrier) angesehen. Zur Abschätzung der Sensibilisierungsfähigkeit kann daher auch die Reaktivität der Substanz oder ihrer Metaboliten gegenüber Proteinen herangezogen werden. Im Rahmen dieser Arbeit werden neben dem bedeutenden Phytoekzematogen Tulipalin A die bisher wenig untersuchten kontaktallergenen Duftstoffe Geraniol, 7-Hydroxycitronellal, Benzaldehyd, Salicylaldehyd, Vanillin, Zimtaldehyd, a-Amyl-zimtaldehyd und Benzylcinnamat hinsichtlich ihrer Reaktivität gegenüber peptidgebundenen Aminosäuren untersucht. Verwendet werden für diese Modellversuche Hippuryl-Derivate und Acetyl-Derivate der Aminosäuren Lysin, Histidin, Arginin bzw. Cystein sowie zusätzlich Glutathion. Die dabei gewählten Bedingungen sollen eine Adaption an physiologische Gegebenheiten erlauben. Ziel ist es, zu klären, ob die mit diesen Modellversuchen zu gewinnenden Ergebnisse mit dem bekannten kontaktallergenen Potential der eingesetzten Haptene korrelieren und somit geeignet sind, die Sensibilisierungsfähigkeit einer Substanz vorherzusagen. Über Konjugationsprodukte von Kontaktallergenen mit Peptiden oder Proteinen ist in der Literatur sehr wenig bekannt. Daher ist es ein weiteres Ziel dieser Arbeit, individuelle Produkte der Reaktionen der kontaktallergenen Substanzen mit den nukleophilen Aminosäureseitenketten zu isolieren und zu charakterisieren, um so definierte Hapten-Carrier-Konjugate, die unter physiologisch relevanten Bedingungen entstehen können, zu beschreiben. Aufbauend auf den gefundenen Strukturen sollte es auch möglich sein, Hinweise auf eventuelle Reaktionsmechanismen zu erhalten.

En el presente trabajo de investigación, se desarrolló un plan de negocios para la venta de peluches antialérgicos dirigido a jóvenes y adultos con alergias y amantes de los obsequios personalizados, con la finalidad de garantizar a los consumidores un producto apto para sus necesidades y problemas en relación a las alergias ocasionadas por este producto. Para el desarrollo del proyecto, se analizó cada aspecto de la propuesta bajo el BMC del mismo, el cual se complementa mediante el análisis de las necesidades perfil del cliente. Asimismo, se llevó a cabo la investigación de la competencia, aspectos de tropicalización y adaptación del producto a las necesidades del cliente. También, con la finalidad de lograr validar el modelo de negocio del proyecto, se formularon hipótesis las cuales serían validadas por medio de experimentos como el Producto Mínimo Viable (MVP). Finalmente, la metodología utilizada para el presente trabajo fue Lean Startup. A partir de ello, se establecieron los planes estratégicos, responsabilidad social, recursos humanos, estrategias de marketing, teórica como financieramente, con la valorización del proyecto. / In the present paper, it was developed a business plan for the sale of anti-allergic plush toys targeted to young people and adults with allergies and lovers of personalized gifts, in order to ensure consumers a product suitable for their needs and problems in relation to allergies caused by this product. For the development of the project, each aspect of the proposal was analyzed under the BMC project, which is enhanced by the analysis of the necessities and profile of the client. Likewise, it carried out the analysis of the competition, aspects of tropicalization and adaptation of the product to the clients' needs. In addition, in order to validate the project's business model, hypotheses were formulated which would be validated through experiments such as the Minimum Viable Product (MVP). Finally, the methodology applied for this paper is Lean Startup. Based on this, the strategic plans, social responsibility, human resources, marketing strategies, both theoretically and financially, were established with the valorization of the project. / Trabajo de investigación

Allergy is one of the most common diseases. Identification of early prognostic markers pointing to an increased risk of allergy development is therefore of increasing importance. Cord blood represents an easily attainable clinical material for searching for prognostic markers signalizing future allergy development. Proportions of Th1 cytokines, Th2 cytokines and regulatory cytokines were tested in cord blood of children of allergic mothers (children in relatively high risk of allergy development) in comparison with cord blood of children of healthy mothers (low risk children). Also the activities of lymphocytes, dendritic cells (DC) and regulatory cells (Tregs) were compared in children of healthy and allergic mothers. The generally increased activity of both in vitro stimulated and non-stimulated mononuclear cord blood leukocytes was proved in children of allergic mothers in comparison with low risk children. The increased activity of DC of high risk children was detectable only after polyclonal stimulation. Significantly less pronounced functional properties of cord blood Tregs were found in children of allergic mothers when compared with children of healthy mothers. The increased reactivity of lymphocytes and DC together with the decreased activity of Tregs can support an easier...

Regulatorische T-Zellen (Tregs) spielen eine entscheidende Rolle bei der Regulation atopischer Erkrankungen. Die Voraussetzungen für eine allergische Reaktionslage werden schon während der intrauterinen Entwicklung geschaffen. Über den Einfluss der intrauterinen Umgebung auf die Tregs zur Geburt ist bisher wenig bekannt. In der vorliegenden Arbeit sollte in der prospektiven Geburtskohorten-Studie LINA (Einfluss von Lebensstil und Umweltfaktoren auf das Allergierisiko Neugeborener) geklärt werden, inwiefern der Immunstatus der werdenden Mutter, eine atopische Familienanamnese sowie Umweltexpositionen während der Schwangerschaft den Immunstatus der Neugeborenen beeinflussen. Ein besonderer Schwerpunkt wurde dabei auf Tregs gelegt. Weiterhin sollte die Relevanz der Tregs zur Geburt für das Allergierisiko im ersten Lebensjahr des Kindes analysiert werden. Die Messung der Anzahl und Funktionalität der Tregs im Blut der werdenden Mutter in der 34. Schwangerschaftswoche und im Nabelschnurblut erfolgte sowohl durchflusszytometrisch in einer Subkohorte (n=24 Mutter-Kind Paare), als auch durch eine methylspezifische qPCR in der gesamten Kohorte der LINA-Studie (n=346 Mutter-Kind Paare). Die Ergebnisse dieser Arbeit deuten erstmals darauf hin, dass mütterliche Tregs möglicherweise einen regulatorischen Einfluss hinsichtlich der Programmierung des fötalen Immunsystems haben (Hinz et al., Clin Exp Allergy 2010). Die durchflusszytometrische Charakterisierung der Tregs der Mutter-Kind Paare zeigte beim Vergleich der Expression von CD4, CD25, CD127 und FOXP3, dass der Anteil der CD4+CD25high Tregs im Nabelschnurblut deutlich höher war, der Anteil FOXP3 positiver Zellen innerhalb der CD4+CD25high Tregs Population war zur Geburt jedoch signifikant geringer, verglichen mit den werdenden Müttern. Weiterhin war eine geringe Anzahl mütterlicher Tregs während der Schwangerschaft und eine erhöhte Produktion der TH2-Zytokine IL-4, IL-5 und IL-13 mit erhöhten Gesamt-IgE-Spiegeln im Nabelschnurblut verbunden (Hinz et al., 2010). Durch die Quantifizierung der Tregs auf Basis des TSDR-Methylierungsstatus` im FOXP3 Gen, einer spezifischen und zuverlässigen Methode zum Nachweis stabiler Tregs, konnte der Zusammenhang zwischen einer Vielzahl pränataler Faktoren, Tregs zur Geburt und dem Allergierisiko in der gesamten Geburtskohorte geklärt werden (Hinz et al., Allergy 2011). Das männliche Geschlecht des Kindes, die Atopie der Eltern, Rauchen und Desinfektionsmittel-Exposition während der Schwangerschaft sowie eine erhöhte mütterliche Produktion von IFN-γ, IL-13 und IL-17E war mit einer geringeren Treg-Anzahl im Nabelschnurblut assoziiert. Für Kinder mit einer geringeren Treg-Anzahl im Nabelschnurblut war das Risiko für eine atopische Dermatitis und einer Sensibilisierung gegen Nahrungsmittelallergene im ersten Lebensjahr signifikant höher (Hinz et al., 2011).:Bibliografische Beschreibung II Abkürzungsverzeichnis IV 1. Einleitung 1 1.1. Hintergrund der Untersuchungen 1 1.2. Historischer Hintergrund/Definition „Allergie“ 1 1.3. T-Zellpopulationen mit Relevanz für die Entwicklung allergischer Erkrankungen 2 1.4. Regulatorische T-Zellen 5 1.5. Bedeutung des Immunstatus zur Geburt - prädiktive Marker für die Allergieentstehung 8 1.6. Ursachen der frühkindlichen Allergieentstehung – genetische Prädisposition und pränatale Umgebung 10 1.7. Die LINA-Studie 13 2. Zielstellung 15 3. Originaldateien 16 4. Diskussion 34 4.1. Unterschiede im Phänotyp und der Funktion der Tregs in der Schwangerschaft und zur Geburt 36 4.2. Zusammenhang zwischen dem Immunstatus der werdenden Mutter und dem des Kindes zur Geburt 37 4.3. Geschlechtsspezifische Unterschiede in der Anzahl der Tregs zur Geburt 41 4.4. Zusammenhänge zwischen der familiären Prädisposition und der Anzahl der Tregs im Nabelschnurblut 42 4.5. Zusammenhänge zwischen Umweltfaktoren während der Schwangerschaft und der Anzahl der Tregs im Nabelschnurblut 44 4.6. Zusammenhang zwischen der Anzahl der Tregs zur Geburt, Sensibilisierung und allergischen Erkrankungen im ersten Lebensjahr des Kindes 46 4.7. Stärken und Schwächen der Untersuchungen 47 5. Zusammenfassung 49 6. Literaturverzeichnis 52 Anlage – Supplemental Materials 66 Hinz et al., Clin Exp Allergy 2010 66 Hinz et al., Allergy 2011

Tinea pedis is a chronic fungal infection of the feet, very often observed in patients who are immuno-suppressed or have diabetes mellitus. The practicing allergist may be called upon to treat this disease for various reasons. Sometimes tinea infection may be mistaken for atopic dermatitis or allergic eczema. In other patients, tinea pedis may complicate allergy and asthma and may contribute to refractory atopic disease. Patients with recurrent cellulitis may be referred to the allergist/immunologist for an immune evaluation and discovered to have tinea pedis as a predisposing factor. From a molecular standpoint, superficial fungal infections may induce a type2 T helper cell response (Th2) that can aggravate atopy. Th2 cytokines may induce eosinophil recruitment and immunoglobulin E (IgE) class switching by B cells, thereby leading to exacerbation of atopic conditions. Three groups of fungal pathogens, referred to as dermatophytes, have been shown to cause tinea pedis: Trychophyton sp, Epidermophyton sp, and Microsporum sp. The disease manifests as a pruritic, erythematous, scaly eruption on the foot and depending on its location, three variants have been described: interdigital type, moccasin type, and vesiculobullous type. Tinea pedis may be associated with recurrent cellulitis, as the fungal pathogens provide a portal for bacterial invasion of subcutaneous tissues. In some cases of refractory asthma, treatment of the associated tinea pedis infection may induce remission in airway disease. Very often, protracted topical and/or oral antifungal agents are required to treat this often frustrating and morbid disease. An evaluation for underlying immuno-suppression or diabetes may be indicated in patients with refractory disease.

Influenza is a preventable infectious disease, against which vaccination is the primary means of protection. Health care workers (HCW) are among the most vulnerable to the illness and are likely to be sources of infection transmission while caring for patients. Circumstantial evidence suggests higher rates of vaccination coverage by HCW will coincide with a lower incidence of influenza transmission, yet a gap remains in the literature regarding governing health agencies' (i.e., licensing boards, medical and nursing associations) influence on the influenza vaccination practices of their constituents. Moreover, discrepancies exist between governing health agencies' and the National Vaccine Advisory Committee's recommendations on mandatory influenza vaccination for HCW. The main purpose of this quantitative cross-sectional study was to explore the relationship between influenza vaccination uptake by HCW and guidance from governing health agencies to vaccinate. The health belief model and social cognitive theory were used to identify the most influential determinant for HCW to vaccinate against influenza. The sample consisted of 388 HCW who provided direct patient care at the same hospital. Data were analyzed using Fisher's exact test. Study findings suggest that a workplace mandate for influenza vaccination has an influence on HCW uptake of the vaccine and that governing agencies' lack of uniformity on the matter has minimal impact on their constituents' beliefs and behavior. It is recommended that a universal policy be adopted for health agencies' implementation of an influenza vaccine mandate, which could lead to positive social change by supporting preventive self-care practices, minimizing spread of the disease to workers and patients, and maintaining workplace productivity.

Nonalcoholic fatty liver disease (NAFLD) has become one of the most common hepatic diseases worldwide, making the diagnosis and management of NAFLD an emerging public health issue. Theories associated with NAFLD surmise that inflammation may be the root cause, along with the complex interplay of other chronic conditions such as obesity, metabolic syndrome, diabetes, dyslipidemia, and cardiovascular disease (CVD). It is unknown if other inflammatory conditions such as rheumatoid arthritis (RA), along with the use of methotrexate (MTX), might confer increased risk for NAFLD. Longitudinal data collected from a retrospective cohort of 17,481 adult RA patients in the United States were used to determine the incidence and factors associated with the development of NAFLD using a noninvasive tool (Fibrosis-4 score). Results of the Kaplan Meier analysis showed that 31% of this cohort developed NAFLD, in about 7 years from baseline, with most having mild to moderate disease and only 1.4% with advanced disease. RA patients also had a prevalence of chronic conditions associated with NAFLD, as seen in the general population. In the Cox proportional hazard multivariate analysis, age (middle and elderly), hypertension, CVD, dyslipidemia, metabolic syndrome, exercise, use of MTX, and non-MTX antirheumatic drugs were independent predictors for the development of NAFLD. This research could improve early diagnosis of NAFLD using a novel noninvasive tool. Increase awareness of the prevalence and causes of NALFD inform clinical practice and management of the disease and influence policy about this chronic condition in patients with RA.

No description available.

Background: Lifestyle and environmental factors are known to contribute to allergic disease development, especially very early in life. However, the link between diet composition and allergic outcomes remains unclear. Methods: In the present population-based cohort study we evaluated the dietary intake of 10-year-old children and analyses were performed with particular focus on atopic dermatitis or food allergy, allergic diseases known to be affected by dietary allergens. Dietary intake was assessed via semi-quantitative food frequency questionnaires. Based on these data, individual nutrient intake as well as children’s Dietary Inflammatory Index (C-DIITM) scores were calculated. Information about atopic manifestations during the first 10 years of life and confounding factors were obtained from standardized questionnaires during pregnancy and annually thereafter. Results: Analyses from confounder-adjusted logistic regression models (n = 211) revealed that having atopic outcomes was associated with having a pro-inflammatory pattern at the age of 10 years: OR = 2.22 (95% CI: 1.14–4.31) for children with atopic dermatitis and OR = 3.82 (95% CI: 1.47–9.93) for children with food allergy in the first 10 years of life Conclusion: A pro-inflammatory dietary pattern might worsen the atopic outcome and reduce the buffering capacity of the individual against harmful environmental exposures or triggers. For pediatricians it is recommended to test for the individual tolerance of allergenic foods and to increase the nutrient density of tolerable food items to avoid undesirable effects of eating a pro-inflammatory diet.

Indiana University-Purdue University Indianapolis (IUPUI) / Rationale: Tissue remodeling and complement activation are asthma hallmarks. Type V collagen [col(V)], a cryptic antigen, becomes exposed during lung remodeling. IL-17 is key to anti-col(V) immunity, and regulates complement activation. We have reported that col(V)-induced tolerance down regulates IL-17 and prevents immune-mediated lung diseases. Objectives: Determine a role for anti-col(V) immunity in asthma. Methods: Serum anti-col(V) antibodies were measured in asthma patients, and immunohistochemistry utilized to detect interstitial col(V) in fatal asthma. Balb/c mice were tolerized with col(V) prior to sensitization with ovalbumin (OVA), and subsequent OVA intranasal challenge. Airway hyper-responsiveness (AHR) to methacholine was measured; and RT-PCR utilized to determine local Il17 transcripts. Bronchoalveolar lavage levels of C3a¸ C5a and OVA-specific IgE were measured; and immunohistochemistry utilized to detect expression of complement regulatory proteins, expression, CD46/Crry and CD55, in lung tissue. Results: Compared to normal subjects, anti-col(V) antibodies were increased in asthmatics; and interstitial col(V) was over expressed in fatal asthma. OVA-induced AHR up regulated anti-col(V) antibodies systemically, and increased OVA-specific IgE and C3a in BAL, and parenchymal Il17 transcripts. Col(V)-induced tolerance abrogated AHR, down regulated OVA-induced T cell proliferation, as well as total and OVA-specific IgE, C3a, IL-17 expression and tracheal smooth muscle contraction. Crry/CD46 and CD55, key to preventing complement activation, were down regulated on goblet cells in murine allergic airway disease. Conclusions: Anti-col(V) immunity correlates with asthma pathogenesis, and col(V)-induced tolerance may be a novel therapeutic for asthma. Decreased expression of Crry/CD46 and CD55 on goblet cells may in part account for complement activation in asthma.